Diagnostics of suicidal behavior and suicide risk evaluation. Report I

Based on a systematic analysis of literature data and clinical experience, the article gives methodological recommendations on the diagnosis of suicidal behavior (SB) and its risk as an integral part of general medical routine and psychiatric practices. Multilateral suicidological analysis includes psychiatric, somato-neurological, social aspects: it is necessary to identify a psychopathological syndrome (clinical picture), a possible combination (comorbidity) with personality disorder, dependence on psychoactive substances, bodily and / or neurological diseases, identify topical psychosocial problems (measure of distress), the level of social disadaptation as possible "targets" for subsequent biopsychosocial crisis interventions. Clinical (medical) risk assessment means a reasoned combined analysis of the interrelated aspects and comparison of biopsychosocial suicidal and antisuicide (protective) factors on the individual and group levels (correlation of the suicide with the risk group of the SB), the physical and mental state of the patient (the subject). The risk is strengthened by a combination of synergistically summarized suicidal factors in the depletion of protective ones. In an individual risk analysis of SB, both suicidal and antisuicidal factors are compared, a personality-situational conflict and suicidal motives are revealed. After an individual diagnosis of risk, the SB "client" is correlated with a certain risk group of the SB. In the next report, the co-authors will report on the relationship between group risk factors and anti-suicide (protective) factors of the SB as the basis for scientifically evidence-based choice of conditions and content of biopsychosocial crisis assistance.